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Measles outbreak affects 56 people in New York
Since March, there have been 56 confirmed cases of measles in two Orthodox Jewish communities in Borough Park and Williamsburg, Brooklyn, according to information from the New York City Department of Health and Mental Hygiene.
All cases involve adults and children aged 0 to 32 years who were not vaccinated because of refusal or delays in vaccination. There have been two hospitalizations and no deaths reported.
Health department officials have met with pediatricians, school administrators and community leaders in the two neighborhoods to try and encourage vaccination.
Measles outbreaks also occurred in Borough Park in 2008, 2009 and 2011.
The first dose of measles-mumps-rubella vaccine should be given at aged 6 months to all children in the Orthodox Jewish communities of Borough Park, Williamsburg and Crown Heights, health department officials said.
Although there have been no cases of measles in Crown Heights, they are recommending vaccination to help prevent introduction.
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Since April 2013, more than 50 cases of measles have been confirmed among the Jewish Orthodox communities in Brooklyn, N.Y.
The initial case was a traveler from London, where large numbers of cases of measles continue to occur related to sub-optimal rates of immunization. All cases in this outbreak have occurred in unvaccinated individuals. The median age of the cases is 2 years (range: 10 months to 17 years). Two people have been hospitalized due to complications, one developed pneumonia and one suffered a miscarriage. To date there have been no cases of encephalitis or deaths reported. Additionally, more than 2,000 people have been exposed to the virus in households, apartment buildings, provider offices and community gatherings.
Although the reasons for this outbreak are not completely understood, the combination of large family size, living in close quarters, frequent community gatherings, and sub-optimal vaccination rates have likely contributed to the spread of measles. Additionally many of the children in the community attend private schools, where vaccine requirements and disease surveillance may not be rigidly enforced.
In an effort to control this epidemic, the New York City Department of Health has recommended the following: 1) All children aged 12 months and older who live in the affected areas and who have received their first MMR vaccine should receive a second dose now if they are at least 28 days from the initial dose; and 2) Orthodox Jewish children between the ages of 6 months to 11 months who live in the affected communities should receive a dose of MMR. Although this dose should provide protection during this outbreak, these infants will still require two doses of MMR after 12 months of age.
This outbreak emphasizes that vaccine preventable diseases can (and do) take hold when introduced into communities in the setting of under-immunization. Furthermore, this outbreak highlights the high degree of contagion and potential seriousness of measles. The institution of public health measures as outlined above and public education in the involved communities will hopefully help interrupt this outbreak and improve timely immunization to prevent future outbreaks.